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Erschienen in: Neuroradiology 1/2011

01.01.2011 | Interventional Neuroradiology

Early fatal hemorrhage after endovascular cerebral aneurysm treatment with a flow diverter (SILK-Stent)

Do we need to rethink our concepts?

verfasst von: Bernd Turowski, Stephan Macht, Zolt Kulcsár, Daniel Hänggi, Walter Stummer

Erschienen in: Neuroradiology | Ausgabe 1/2011

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Abstract

A 69-year-old woman presenting with short lasting recent episodes of visual impairment was treated uneventfully with a flow diverter covering the neck of a large paraophthalmic aneurysm. As angiography showed immediate flow reduction we abstained from additional coiling which was initially planned. Eleven days later CT demonstrated nearly complete thrombosis of the aneurysm. Twenty days after treatment the patient suffered a lethal subarachnoid hemorrhage after rupture of the aneurysm. All available data were reviewed and beside hemodynamic factors instability of the intra-aneurysmal thrombus is discussed as a possible cofactor leading to this disastrous event.
Literatur
1.
Zurück zum Zitat Sluzewski M, Menovsky T, vanRooij W, Wijnalda D (2003) Coiling of very large or giant cerebral aneurysm: long-term clinical and serial angiographic results. AJNR 24(2):257–262PubMed Sluzewski M, Menovsky T, vanRooij W, Wijnalda D (2003) Coiling of very large or giant cerebral aneurysm: long-term clinical and serial angiographic results. AJNR 24(2):257–262PubMed
2.
Zurück zum Zitat Zhao ZW, Deng JP, Gao GD (2007) Angiographic outcomes of cerebral aneurysms embolized with Matrix coils. Zhonghua Yi Xue Za Zhi 87:37–40PubMed Zhao ZW, Deng JP, Gao GD (2007) Angiographic outcomes of cerebral aneurysms embolized with Matrix coils. Zhonghua Yi Xue Za Zhi 87:37–40PubMed
3.
Zurück zum Zitat Grunwald IQ, Papanagiotou P, Struffert T et al (2007) Recanalization after endovascular treatment of intracerebral aneurysms. Neuroradiology 49(1):41–47CrossRefPubMed Grunwald IQ, Papanagiotou P, Struffert T et al (2007) Recanalization after endovascular treatment of intracerebral aneurysms. Neuroradiology 49(1):41–47CrossRefPubMed
4.
Zurück zum Zitat Cebral JR, Castro MA, Appanaboyina S, Putman CM, Millan D, Frangi AF (2005) Efficient pipeline for image-based patient-specific analysis of cerebral aneurysm hemodynamics: technique and sensitivity. IEEE Trans Med Imaging 24(4):457–467CrossRefPubMed Cebral JR, Castro MA, Appanaboyina S, Putman CM, Millan D, Frangi AF (2005) Efficient pipeline for image-based patient-specific analysis of cerebral aneurysm hemodynamics: technique and sensitivity. IEEE Trans Med Imaging 24(4):457–467CrossRefPubMed
5.
Zurück zum Zitat Radaelli AG, Augsburger L, Cebral JR et al (2008) Reproducibility of haemodynamical simulations in a subject-specific stented aneurysm model—a report on the Virtual Intracranial Stenting Challenge 2007. J Biomech 41(10):2069–2081CrossRefPubMed Radaelli AG, Augsburger L, Cebral JR et al (2008) Reproducibility of haemodynamical simulations in a subject-specific stented aneurysm model—a report on the Virtual Intracranial Stenting Challenge 2007. J Biomech 41(10):2069–2081CrossRefPubMed
6.
Zurück zum Zitat Wanke I, Forsting M (2008) Stents for intracranial wide-necked aneurysms: more than mechanical protection. Neuroradiology 50(12):991–998CrossRefPubMed Wanke I, Forsting M (2008) Stents for intracranial wide-necked aneurysms: more than mechanical protection. Neuroradiology 50(12):991–998CrossRefPubMed
7.
Zurück zum Zitat Ahlhelm F, Roth C, Kaufmann R, Schulte-Altedorneburg G, Romeike BF, Reith W (2007) Treatment of wide-necked intracranial aneurysms with a novel self-expanding two-zonal endovascular stent device. Neuroradiology 49(12):1023–1028CrossRefPubMed Ahlhelm F, Roth C, Kaufmann R, Schulte-Altedorneburg G, Romeike BF, Reith W (2007) Treatment of wide-necked intracranial aneurysms with a novel self-expanding two-zonal endovascular stent device. Neuroradiology 49(12):1023–1028CrossRefPubMed
8.
Zurück zum Zitat Kallmes DF, Ding YH, Dai D, Kadirvel R, Lewis DA, Cloft HJ (2007) A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke 38(8):2346–2352CrossRefPubMed Kallmes DF, Ding YH, Dai D, Kadirvel R, Lewis DA, Cloft HJ (2007) A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke 38(8):2346–2352CrossRefPubMed
9.
Zurück zum Zitat Fiorella D, Kelly ME, Albuquerque FC, Nelson PK (2009) Curative rconstruction of a giant midbasilar trunk aneurysm with the pipeline embolization device: Case report. Neurosurgery 64(2):212–217CrossRefPubMed Fiorella D, Kelly ME, Albuquerque FC, Nelson PK (2009) Curative rconstruction of a giant midbasilar trunk aneurysm with the pipeline embolization device: Case report. Neurosurgery 64(2):212–217CrossRefPubMed
10.
Zurück zum Zitat Fiorella D, Woo HH, Albuquerque FC, Nelson PK (2008) Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 62(5):1115–1120CrossRefPubMed Fiorella D, Woo HH, Albuquerque FC, Nelson PK (2008) Definitive reconstruction of circumferential, fusiform intracranial aneurysms with the pipeline embolization device. Neurosurgery 62(5):1115–1120CrossRefPubMed
11.
Zurück zum Zitat Kirchhof K, Welzel T, Mecke C, Zoubaa S, Sartor K (2003) (2003)Differentiation of white, mixed, and red thrombi: value of CT in estimation of the prognosis of thrombolysis phantom study. Radiology 228:126–130CrossRefPubMed Kirchhof K, Welzel T, Mecke C, Zoubaa S, Sartor K (2003) (2003)Differentiation of white, mixed, and red thrombi: value of CT in estimation of the prognosis of thrombolysis phantom study. Radiology 228:126–130CrossRefPubMed
12.
Zurück zum Zitat Blinc A, Keber D, Lahajnar G, Zupancic I, Zorec-Karlovsek M, Demsar F (1992) Magnetic resonance imaging of retracted and nonretracted blood clots during fibrinolysis in vitro. Haemostasis 22(4):195–201PubMed Blinc A, Keber D, Lahajnar G, Zupancic I, Zorec-Karlovsek M, Demsar F (1992) Magnetic resonance imaging of retracted and nonretracted blood clots during fibrinolysis in vitro. Haemostasis 22(4):195–201PubMed
13.
Zurück zum Zitat Blinc A, Kennedy SD, Bryant RG, Marder VJ, Francis CW (1994) Flow through clots determines the rate and pattern of fibrinolysis. Thromb Haemost 71(2):230–235PubMed Blinc A, Kennedy SD, Bryant RG, Marder VJ, Francis CW (1994) Flow through clots determines the rate and pattern of fibrinolysis. Thromb Haemost 71(2):230–235PubMed
14.
Zurück zum Zitat Carr ME Jr, Hardin CL (1987) Fibrin has larger pores when formed in the presence of erythrocytes. Am J Physiol 253:H1069–H1073PubMed Carr ME Jr, Hardin CL (1987) Fibrin has larger pores when formed in the presence of erythrocytes. Am J Physiol 253:H1069–H1073PubMed
15.
Zurück zum Zitat Weisel JW, Litvinov RI (2008) The biochemical and physical process of fibrinolysis and effects of clot structure and stability on the lysis rate. Cardiovasc Hematol Agents Med Chem 6:161–180CrossRefPubMed Weisel JW, Litvinov RI (2008) The biochemical and physical process of fibrinolysis and effects of clot structure and stability on the lysis rate. Cardiovasc Hematol Agents Med Chem 6:161–180CrossRefPubMed
16.
Zurück zum Zitat Gacko M, Glowinski S (1998) Activities of proteases in parietal thrombus of aortic aneurysm. Clin Chim Acta 271:171–177CrossRefPubMed Gacko M, Glowinski S (1998) Activities of proteases in parietal thrombus of aortic aneurysm. Clin Chim Acta 271:171–177CrossRefPubMed
17.
Zurück zum Zitat Wohner N (228) Role of cellular elements in thrombus formation and dissolution. Cardiovasc Hematol Agents Med Chem 6:224–228CrossRef Wohner N (228) Role of cellular elements in thrombus formation and dissolution. Cardiovasc Hematol Agents Med Chem 6:224–228CrossRef
18.
Zurück zum Zitat Bendszus M, Hagel C, Maurer M et al (2006) Fatal recurrent subarachnoid hemorrhage after complete endovascular aneurysm occlusion. AJNR Am J Neuroradiol 27:2058–2060PubMed Bendszus M, Hagel C, Maurer M et al (2006) Fatal recurrent subarachnoid hemorrhage after complete endovascular aneurysm occlusion. AJNR Am J Neuroradiol 27:2058–2060PubMed
Metadaten
Titel
Early fatal hemorrhage after endovascular cerebral aneurysm treatment with a flow diverter (SILK-Stent)
Do we need to rethink our concepts?
verfasst von
Bernd Turowski
Stephan Macht
Zolt Kulcsár
Daniel Hänggi
Walter Stummer
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 1/2011
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-010-0676-7

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